Doctor Name: | EVERT GENE SIEBERT |
NPI Number: | 1235103656 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LAT, ATC |
License Number: | 36001269A |
Business Practice Address: | 7th Street Indiana State University, Arena Building Terre Haute, IN - 47807 |
Business Phone Number: | 8122499468 |
Business Fax Number: | |
Mailing Address: | 630 Elm St, Apt 3 TERRE HAUTE |
State: | IN |
Postal Code: | 478072046 |
Phone Number: | 8122499468 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 36001269A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |